HomeMy WebLinkAbout07030092 Application
City of Carmel/Clay Township Permit #:() 70-8orYt;c
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
E A'f rfV(,.. CvNS~\lLl1 O~
PHONE
514 - 5"'\-'8'i?
FAX
51 - 54-8'"'2..
STREET ADDRESS
c)'B.30 ~Et2-
BUILDER'S EMAIL ADDRESS
..,.-- Cl..A /\1), l'DL ez:.JsTi2.\)cr. toN1
STATE
:pi
ZIP
4u7ED
BEST METHOD OF CONTACT:
DI'1e..-
PROPERTY
OWNER:
NAME
MA.Ch> \ t-.l~ 12.EAL:
STREET ADDRESS
DO ~/S/1)NE
PHONE
2- 4C\-D2lD I
CITY
IA/DPL.S
FAX
STATE
IN
ZIP
4-112-4 0 ,
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
04 tJ. M ICH I C:t ~ 'g..o
SUITE # (If Applicable)
150
Address of Shell Building (If different than Address of Construction)
lot # and Subdivision (If Applicable)
BII~Me~E~~~ NA~eb ~N1 Det-Sr f>.L-
STATE COMMERCIAL SCOPE(S) OF 0 FDN
DESIGN RELEASE #: ? 74\ uv RELEASE: r7 ELEC
ZONING:
l2-4-
SQUARE
FOOTAGE: , '5-z.E.
.
TAX MAP PARCEL #:
o STR ~ ARCH ZMECH
o SPKUR OTHER(S):
WATER UTILITY f)__ '_~ I SEWER UTILITY
PROVIDER: ~ Li!f)' U;j PROVIDER:
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
c;
EST1MATED COST OF CONSTRUCTIO)f
(EXCLUDING LAND VALUE) 't> (2:ff j D"DC)
# of Floors:
Elevator or Uft: 0 YES ~ NO
OCCUPANCY CLASSIFICATION:
-~
TYPE OF CONSTRUrnON: TYPE O!.l.'tIPROVEMENT:
r:f. COMMEROAL o~~,STRUCTURE
(Privately owned hospitals ,.. r ~,~ S\ \ " ,~~~YfION
and medical officeS/centePS"~ ;~ __J " ~ a,\\ ~_e_' 0 Room(s)
arecommer~-\ \-'- CB'if\!~'!!c, e,eS-, ;;49orch
o IN~AL~r;,m?\\~\\}ll(i~GOC.r;.?-\1~\~ ~nlneorOe<:k
iBt:f;fY:ni!i!pal""U~~e Ill"\!" "l\'f{ "b
af,Il~fiool<6\ S\.<;. r;;N.~\J\'" ,{ jii1 EW TENANT FINISH
o Church :r:,'(' G~ ~ i I elf'. 0 ACCESSORY BUILDING
FOUNDATION~=1(9'~ck'_11I~l:h j:>.~j:>. 0 DETACHED GARAGE
apply for the n~,~~&Uetfon a~\ 0 ATTACHED GARAGE
;6 SLAB C'i D' CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y -LN Trusses: _Y /' N
Lot Split: _Y LN Sump Pump: _Y .r.N
,
Does any part of the property lie within a special Flood "'0
\ \ '
designation area: _Y....LN ".. ' \~)
PLUMBING CONTRACTOR:.. /:; '; I'J~ \ ':)
"Beu... "PLvN\~Ni9 .. '\ '\; ,,)
\ \ \. \ /'
Plumber's Indiana State License #: ~~~ // /
~<t'(; boL(4'ir -\ ~/./
,/ ./
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding e~pi}~tion timebmes for
. beginning and completing construction. /
I, the undersigned, agree that any construction, reconstruction, enlargement. relocation, or alteration of a structure, or any change in the use..of land or structutes
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
28 and amendments, adopted under authOrity of I.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kit en, bath, and floQr drai s are connected to the sanitary sewer, I further certify that the construction will not be used or occupied until a Certificate of
upancy or Substan' ompJetion has been issued by the Department of Conununity Services, Carmel, Indiana.
~nrr\1 ~J\'iJn
thorized gent .Print 11
()") t?1 ())
Date
OFFICE USE ONLY: ********* ********** *** * ******* ** ******** *** **** * *** ******** * *** * ******* *
011 ~, 3?
-7 (J A>. ~ # Chamed Re-
/\...- lY vV ReViews
() 7, (J'f)
o ~
INSPEcnONS REQUIRED:
Filing Fees:
Upper Footing Lower Footing Under Slab
Meter Base G Site
Base Inspections:
Cert. of Occupancy:.
7
TAL:
~-\S.()
(Dale)
Additional Fees
Fee Received by: